Circulation, Vol 88, 245-249, Copyright © 1993 by American Heart Association
JJ Langberg, M Gallagher, SA Strickberger and O Amirana
BACKGROUND. Previous studies have shown that the size of lesions produced
by radiofrequency catheter ablation correlates with the temperature and
surface area of the electrode-tissue interface. The purpose of the present
study was to compare the effects of ablation using very large distal
electrodes (8F, 8 and 12 mm long) with those made by a conventional
radiofrequency ablation catheter (distal electrode 8F, 4 mm long). METHODS
AND RESULTS. Each catheter had a thermistor in the tip of the distal
electrode. Radiofrequency energy (500 kHz) was supplied by a generator that
continuously monitored temperature and produced up to 100 W. In 10 dogs,
each of the three ablation catheters were introduced percutaneously and
positioned under fluoroscopic guidance at disparate left ventricular
endocardial sites. Radiofrequency power output was titrated to achieve a
temperature of 80 degrees C for 60 seconds at each ablation site. The power
required to produce a steady-state temperature of 80 degrees C was directly
proportional to electrode size (15 +/- 7, 46 +/- 15, and 62 +/- 32 W using
the 4-mm-, 8-mm-, and 12-mm-long electrodes, respectively). Lesions
produced by the 8-mm electrode were nearly twice as deep (11 +/- 2.4 versus
6 +/- 1.2 mm, P < .001) and four times as large (905 +/- 410 versus 210
+/- 100 mm3, P < .001) as those made with a conventional 4- mm
electrode. Lesions produced by the 12-mm electrode were intermediate in
size (depth, 8 +/- 1.2 mm; volume, 465 +/- 225 mm3) and sometimes were
associated with charring and crater formation. Ablation with the larger
electrodes caused a drop in arterial pressure and more ventricular ectopy
than ablation using a 4-mm distal electrode. CONCLUSIONS.
Thermistor-equipped elongated ablation electrodes coupled to high-power
outputs can reproducibly produce lesions approximately 1 cm in diameter.
This system may prove useful for ablation of ventricular tachycardias in
patients with coronary artery disease.
ARTICLES
Temperature-guided radiofrequency catheter ablation with very large distal electrodes
Department of the Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0022.
This article has been cited by other articles:
 |
|
 |
|
  M. Linhart, H. Mollnau, A. Bitzen, S. Wurtz, J. W. Schrickel, R. Andrie, F. Stockigt, C. Weiss, G. Nickenig, L. M. Lickfett, et al. In vitro comparison of platinum-iridium and gold tip electrodes: lesion depth in 4 mm, 8 mm, and irrigated-tip radiofrequency ablation catheters Europace, May 1, 2009; 11(5): 565 - 570. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. E. Eckart and L. M. Epstein Interventional Therapy for Atrial and Ventricular Arrhythmias Card. Surg. Adult, January 1, 2008; 3(2008): 1357 - 1374. [Full Text]
|
|
|
|
 |
|
 K. Yokoyama, H. Nakagawa, F. H.M. Wittkampf, J. V. Pitha, R. Lazzara, and W. M. Jackman Comparison of Electrode Cooling Between Internal and Open Irrigation in Radiofrequency Ablation Lesion Depth and Incidence of Thrombus and Steam Pop Circulation, January 3, 2006; 113(1): 11 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Stagegaard, H. Høg. Petersen, X. Chen, and J. H. Svendsen Indication of the radiofrequency induced lesion size by pre-ablation measurements Europace, January 1, 2005; 7(6): 525 - 534. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. D. Satti and L. M. Epstein Cardiologic Interventional Therapy for Atrial and Ventricular Arrhythmias Card. Surg. Adult, January 1, 2003; 2(2003): 1253 - 1270. [Full Text]
|
|
|
|
 |
|
 S Furniss, R Anil-Kumar, J P Bourke, R Behulova, and E Simeonidou Radiofrequency ablation of haemodynamically unstable ventricular tachycardia after myocardial infarction Heart, December 1, 2000; 84(6): 648 - 652. [Abstract] [Full Text]
|
|
|
|
|
|
C.-F. Tsai, C.-T. Tai, W.-C. Yu, Y.-J. Chen, M.-H. Hsieh, C.-E. Chiang, Y.-A. Ding, M.-S. Chang, and S.-A. Chen Is 8-mm More Effective Than 4-mm Tip Electrode Catheter for Ablation of Typical Atrial Flutter? Circulation, August 17, 1999; 100(7): 768 - 771. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Strickberger, T. Tokano, J.-U. A. Kluiwstra, F. Morady, and C. Cain Extracardiac Ablation of the Canine Atrioventricular Junction by Use of High-Intensity Focused Ultrasound Circulation, July 13, 1999; 100(2): 203 - 208. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. H. Petersen, X. Chen, A. Pietersen, J. H. Svendsen, and S. Haunso Lesion Dimensions During Temperature-Controlled Radiofrequency Catheter Ablation of Left Ventricular Porcine Myocardium : Impact of Ablation Site, Electrode Size, and Convective Cooling Circulation, January 19, 1999; 99(2): 319 - 325. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Nakagawa, F. H. M. Wittkampf, W. S. Yamanashi, J. V. Pitha, S. Imai, B. Campbell, M. Arruda, R. Lazzara, and W. M. Jackman Inverse Relationship Between Electrode Size and Lesion Size During Radiofrequency Ablation With Active Electrode Cooling Circulation, August 4, 1998; 98(5): 458 - 465. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. D. McRury, D. Panescu, M. A. Mitchell, and D. E. Haines Nonuniform Heating During Radiofrequency Catheter Ablation With Long Electrodes : Monitoring the Edge Effect Circulation, December 2, 1997; 96(11): 4057 - 4064. [Abstract] [Full Text]
|
|
|
|
 |
|
 S. Murakami, E. A. Bacha, P. Herve, H. Detruit, A. R. Chapelier, P. G. Dartevelle, G.-M. Mazmanian, and The Paris-Sud University Lung Transplantation Grou INHALED NITRIC OXIDE AND PENTOXIFYLLINE IN RAT LUNG TRANSPLANTATION FROM NON-HEART-BEATING DONORS J. Thorac. Cardiovasc. Surg., May 1, 1997; 113(5): 821 - 829. [Abstract] [Full Text]
|
|
|
|
|
|
H. Kottkamp, G. Hindricks, E. Horst, T. Baal, C. Fechtrup, G. Breithardt, and M. Borggrefe Subendocardial and Intramural Temperature Response During Radiofrequency Catheter Ablation in Chronic Myocardial Infarction and Normal Myocardium Circulation, April 15, 1997; 95(8): 2155 - 2161. [Abstract] [Full Text]
|
|
|
|
|
|
A. Goette, W. Hartung, M. Lesh, C. Honeycutt, S. Fleischman, D. Swanson, and J. Langberg Transcatheter Subendocardial Infusion: A Novel Technique for Mapping and Ablation of Ventricular Myocardium Circulation, September 15, 1996; 94(6): 1449 - 1455. [Abstract] [Full Text]
|
|
|
|
|
|
B. Cauchemez, M. Haissaguerre, B. Fischer, O. Thomas, J. Clementy, and P. Coumel Electrophysiological Effects of Catheter Ablation of Inferior Vena Cava–Tricuspid Annulus Isthmus in Common Atrial Flutter Circulation, January 15, 1996; 93(2): 284 - 294. [Abstract] [Full Text]
|
|
|
|
|
|
J. M. Kalman, R. J. Lee, W. G. Fisher, M. C. Chin, P. Ursell, C. A. Stillson, M. D. Lesh, and M. M. Scheinman Radiofrequency Catheter Modification of Sinus Pacemaker Function Guided by Intracardiac Echocardiography Circulation, November 15, 1995; 92(10): 3070 - 3081. [Abstract] [Full Text]
|
|
|
|
|
|
K. Neya, R. Lee, J. L. Guerrero, P. Lang, and G. J. Vlahakes Experimental Ablation of Outflow Tract Muscle With a Thermal Balloon Catheter Circulation, May 1, 1995; 91(9): 2445 - 2453. [Abstract] [Full Text]
|
|
|
|
|
|
H. Nakagawa, W. S. Yamanashi, J. V. Pitha, M. Arruda, X. Wang, K. Ohtomo, K. J. Beckman, J. H. McClelland, R. Lazzara, and W. M. Jackman Comparison of In Vivo Tissue Temperature Profile and Lesion Geometry for Radiofrequency Ablation With a Saline-Irrigated Electrode Versus Temperature Control in a Canine Thigh Muscle Preparation Circulation, April 15, 1995; 91(8): 2264 - 2273. [Abstract] [Full Text]
|
|
|
|
 |
|
 A. B. Wagshal, L. A. Pires, and S. K. Stephen Management of Cardiac Arrhythmias With Radiofrequency Catheter Ablation Arch Intern Med, January 23, 1995; 155(2): 137 - 147. [Abstract] [PDF]
|
|